Organization
EVERNORTH DIRECT HEALTH LLC
Active
Parent organization
MEDVANTX, INC.
Other names
Mohawk Healthy Life Center-Danville
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-2528
Entity
Organization
Contact information
Practice address
121 MAXINE RD, DANVILLE, VA 24541-6411
(434) 799-5761
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
0024172488
VA
Other
Enumeration date
07/13/2015
Last updated
05/03/2021
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